PLASMA EXCHANGE IN THE TREATMENT OF FULMINANT IDIOPATHIC (AUTOIMMUNE) THROMBOCYTOPENIC PURPURA

摘要: Rapid plasma exchange in a young man with idiopathic (autoimmune) thrombocytopenic purpura and life-threatening haemorrhage acutely increased the platelet-count enhanced haemostasis. The patient had not responded to steroids, massive intra-abdominal bleeding developed after splenectomy, despite numerous platelet transfusions. After exchange, his haemoglobin concentration became normal without further transfusion abdominal girth decreased. Therefore emergency reoperation because of was no longer required. A cumulative-sums plot confirmed that plasmapheresis on 2 occasions followed by pronounced rise mean platelet-count. Neither prednisone nor vincristine therapy altered slope plot. high initial anti-platelet antibody this fell exchange. These findings indicate accelerated clearance circulating factors fulminant purpura.